title: Hyperthermia for the treatment of patients with malignant germ cell tumors: a phase I/II study in ten children and adolescents with recurrent or refractory tumors.
abstract: BACKGROUND
  Extracranial nontesticular germ cell tumors (GCTs) are rare malignancies in children and adolescents. Cisplatin-containing regimens and complete tumor resection are important determinants for a favorable outcome; however, patients with recurrent tumors that cannot be eradicated by surgical procedures and chemotherapy have a poor prognosis. Noninvasive electromagnetic technologies for superficial and regional deep hyperthermia (RHT) are under investigation to enhance local tumor control in various malignancies. The objectives of this Phase I/II study were to examine 1) whether RHT can be used in combination with platinum-based chemotherapy with acceptable toxicity in children and adolescents and 2) whether this combined regimen can induce objective tumor response in patients with malignant nontesticular GCT that persisted or recurred locoregionally after validated, intensive, cisplatin-based chemotherapy +/- surgery as unsuccessful first-line treatment.
  
  
  METHODS
  The authors studied the effects of RHT induced by electromagnetic waves in combination with platinum-based chemotherapy in ten children and adolescents with recurrent or refractory GCTs.
  
  
  RESULTS
  Seven of ten patients with recurrent or refractory GCTs had objective responses. Of these, two patients had a partial response and five patients had a complete response.
  
  
  CONCLUSIONS
  The results of the current study found that combined RHT and platinum-based chemotherapy can be used in children and adolescents. This regimen was found to induce objective tumor response in 70% of study patients with recurrent or refractory GCTs. The results thus far are encouraging and the study has been extended to patients with a poor response to first-line treatment.
authors.affiliation: Department of Pediatric Hematology and Oncology, Heinrich-Heine University, Düsseldorf, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Wessalowski
authors.forename: H
authors.initials: H
authors.lastname: Kruck
authors.forename: H
authors.initials: H
authors.lastname: Pape
authors.forename: T
authors.initials: T
authors.lastname: Kahn
authors.forename: R
authors.initials: R
authors.lastname: Willers
authors.forename: U
authors.initials: U
authors.lastname: Göbel
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001831:Body Temperature; D018236:Carcinoma, Embryonal / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018240:Endodermal Sinus Tumor / Q000628:therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D007223:Infant; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000628:therapy; D009373:Neoplasms, Germ Cell and Embryonal / Q000628:therapy*; D011827:Radiation; D013724:Teratoma / Q000628:therapy; D016896:Treatment Outcome